{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,6]],"date-time":"2026-04-06T05:39:13Z","timestamp":1775453953972,"version":"3.50.1"},"reference-count":34,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2020,4,20]],"date-time":"2020-04-20T00:00:00Z","timestamp":1587340800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cardiovasc electrophysiol"],"published-print":{"date-parts":[[2020,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Pulmonary vein isolation (PVI) is the cornerstone of atrial fibrillation (AF) ablation but the recurrence rate remains relatively high in persistent patients with AF. Therefore, posterior wall isolation (PWI) in addition to PVI has been proposed to increase freedom from AF.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objective<\/jats:title><jats:p>To evaluate the success of adjunctive PWI in persistent AF.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We searched electronic database using specific terms. The primary outcomes are recurrence rate of AF and recurrence of atrial arrhythmias. The secondary outcomes were atrial flutter\/tachycardia (AFL\/AT), procedure time, fluoroscopy time, and procedure related complications. Estimated risk ratios (RRs) and 95% confidence intervals (CIs) were evaluated.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Six studies were included (1334 patients with persistent AF). Adjunctive PWI resulted in a significant reduction in the recurrence rate of AF compared with\u00a0patients who had PVI only (19.8% vs 29.1%; RR, 0.64; 95%\u00a0CI, 0.42\u20100.97; <jats:italic>P<\/jats:italic>\u2009&lt;\u2009.04; <jats:italic>I<\/jats:italic><jats:sup>2<\/jats:sup>\u2009=\u200976%). There was a significant reduction in the recurrence rate of all atrial arrhythmia (30.8% vs 41.1%; RR, 0.75; 95%\u00a0CI, 0.60\u20100.94; <jats:italic>P<\/jats:italic>\u2009&lt;\u2009.01; <jats:italic>I<\/jats:italic><jats:sup>2<\/jats:sup>\u2009=\u200960%). Compared with PVI only, adjunctive PWI did not increase the rate of AFL\u00a0or AT (11.6% vs 13.9%; RR, 0.85; 95% CI, 0.54\u20101.32; <jats:italic>P<\/jats:italic>\u2009&lt;\u2009.46; <jats:italic>I<\/jats:italic><jats:sup>2<\/jats:sup>\u2009=\u200947%) or the rate of procedure related complications (4.6% vs 3.6%; RR, 1.25; 95%\u00a0CI, 0.72\u20102.17; <jats:italic>P<\/jats:italic>\u2009&lt;\u2009.44; <jats:italic>I<\/jats:italic><jats:sup>2<\/jats:sup>\u2009=\u20090%).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>In patients with persistent AF, adjunctive PWI was associated with decreased recurrence of AF and atrial arrhythmias compared with\u00a0PVI alone without an increased risk of AFL or AT\u00a0or procedure related complications.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jce.14480","type":"journal-article","created":{"date-parts":[[2020,4,9]],"date-time":"2020-04-09T07:40:24Z","timestamp":1586418024000},"page":"1394-1402","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":43,"title":["Clinical outcomes of adjunctive posterior wall isolation in persistent atrial fibrillation: A meta\u2010analysis"],"prefix":"10.1111","volume":"31","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6357-8366","authenticated-orcid":false,"given":"Mohsin","family":"Salih","sequence":"first","affiliation":[{"name":"Division of Cardiology Southern Illinois University School of Medicine  Springfield Illinois"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1226-1227","authenticated-orcid":false,"given":"Yousef","family":"Darrat","sequence":"additional","affiliation":[{"name":"Division of Cardiology Catholic Health Initiative Saint Joseph  Lexington Kentucky"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7496-2198","authenticated-orcid":false,"given":"Abdisamad M.","family":"Ibrahim","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Southern Illinois University School of Medicine  Springfield Illinois"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mohammad","family":"Al\u2010Akchar","sequence":"additional","affiliation":[{"name":"Division of Cardiology Southern Illinois University School of Medicine  Springfield Illinois"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mukul","family":"Bhattarai","sequence":"additional","affiliation":[{"name":"Division of Cardiology Southern Illinois University School of Medicine  Springfield Illinois"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cameron","family":"Koester","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Southern Illinois University School of Medicine  Springfield Illinois"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mohamed","family":"Ayan","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine University of Arkansas for Medical Sciences  Little Rock Arkansas"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mohamed","family":"Labedi","sequence":"additional","affiliation":[{"name":"Division of Cardiology Southern Illinois University School of Medicine  Springfield Illinois"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2196-8788","authenticated-orcid":false,"given":"Claude S.","family":"Elayi","sequence":"additional","affiliation":[{"name":"Division of Cardiology Catholic Health Initiative Saint Joseph  Lexington Kentucky"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2020,4,20]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.4103\/2231-0770.173580"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.21037\/jtd.2016.09.13"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/clc.23068"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1136\/heartjnl-2011-301107"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrthm.2006.12.036"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10840-018-0416-1"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCEP.108.797944"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCEP.111.970293"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrthm.2007.01.034"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1093\/europace\/euw231"},{"key":"e_1_2_7_12_1","first-page":"1862","article-title":"Complete isolation of the pulmonary veins and posterior left atrium in chronic atrial fibrillation","volume":"28","author":"Sanders P","year":"2007","journal-title":"Long\u2010term clinical outcome. 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